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Overview of perimenopausal contraception.
1a Frauenklinik , Universitätsspital Basel , Basel , Switzerland.
Climacteric : the Journal of the International Menopause Society
|December 19, 2018
Summary
Choosing contraception during perimenopause requires balancing efficacy, safety, and individual needs. Both copper intrauterine devices and progestogen-only methods offer benefits, while combined hormonal contraceptives present higher risks but also significant advantages.
Area of Science:
- Reproductive Endocrinology
- Gynecology
- Women's Health
Background:
- Perimenopause involves significant biological and psychosocial changes.
- Contraceptive choices are individualized based on efficacy, safety, tolerability, and benefits.
- Age alone does not limit contraceptive options.
Purpose of the Study:
- To review contraceptive methods for perimenopausal women.
- To analyze the efficacy, safety, and benefits of various contraceptive options.
- To guide clinical decision-making for perimenopausal contraception.
Main Methods:
- Review of current literature on contraceptive methods in perimenopause.
- Analysis of safety profiles, efficacy rates, and specific benefits/risks of different methods.
- Consideration of the biopsychosocial profile of individual women.
Main Results:
- Copper intrauterine devices are effective and safe, offering endometrial cancer protection, but unsuitable for heavy bleeding.
- Progestogen-only methods have a favorable cardiovascular profile; long-acting reversible contraceptives are highly effective.
- Combined hormonal contraceptives carry cardiovascular risks and potential cancer promotion but offer substantial benefits like cancer protection and symptom relief.
Conclusions:
- Contraceptive selection in perimenopause is highly individualized.
- Progestogen-based methods and copper intrauterine devices are generally safe and effective options.
- Combined hormonal contraceptives offer significant benefits but require careful risk assessment.
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